PTO/AIA/50 (10‐17)
Approved for use through 03/31/2023. OMB 0651‐0033
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
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REISSUE PATENT APPLICATION TRANSMITTAL
ddress to:
Attorney Docket No.
First Named Inventor
Mail Stop Reissue
Commissioner for Patents
Original Patent Number
P.O. Box 1450
Original Patent Issue Date
Alexandria, VA
22313‐1450
(Month/Day/Year)
Priority Mail Express® Label No.
APPLICATION FOR REISSUE OF:
(Check applicable box) Utility Patent Design Patent Plant Patent
APPLICATION ELEMENTS (37 CFR 1.173) ACCOMPANYING APPLICATION PARTS
1.
Fee
Transmittal
Form
(PTO/SB/56)
11. Statement of status and support for all changes to the
claims.
See 37 CFR 1.173(c).
2.
Applicant
asserts
small
entity status.
See 37 CFR 1.27
12. Power of Attorney
3. Applicant certifies micro entity status.
See 37 CFR 1.29.
Applicant must attach form PTO/SB/15A or B or equivalent.
13. Information Disclosure Statement (IDS)
4. Specification and
Claims in double column copy of patent format
PTOSB/08 or PTO‐1449
(amended, if appropriate)
Copies of citations attached
5. Drawing(s) (proposed amendments, if appropriate)
14. English translation of Reissue Oath/Declaration
6. Reissue Oath/Declaration or Substitute Statement
(if applicable)
(37 CFR 1.175) (PTO/AIA/05, 06, or 07)
15. Return Receipt Postcard (MPEP § 503)
7. Application Data Sheet
NOTE: Benefit claims under 37 CFR 1.78
(Should be specifically itemized)
and foreign priority claims under 37 CFR 1.55 MUST be set forth in an
16. Preliminary Amendment (37 CFR 1.173; MPEP § 1453)
Application Data Sheet (ADS).
8. Original U.S. Patent currently assigned? Yes No
17. Other: ____________________________________________
(If Yes, check applicable box(es))
__________________________________________________
Written Consent of all Assigness (PTO/AIA/53)
__________________________________________________
37 CFR 3.73(c) Statement (PTO/AIA/96)
__________________________________________________
9. CD‐ROM or
CD‐R
in duplicate, Computer Program (Appendix) or large
__________________________________________________
table
__________________________________________________
Landscape Table on CD
10. Nucleotide and/or Amino Acid Sequence Submission
__________________________________________________
(if applicable, items a. – c. are required)
a. Computer Readable Form (CRF)
This
is
a continuation
reissue
or
divisional
reissue
application
b. Specification Sequence Listing on:
(i.e.,
a second
or
subsequent reissue
application
for
the
same
issued
patent).
(Check
box
if
applicable.)
i. CD‐ROM (2 copies) or CD‐R (2 copies); or
ii. Paper
c. Statements verifying identity of above copies
18. CORRESPONDENCE ADDRESS
The address associated with Customer Number: __________________________________ OR Correspondence address below
Name
Address
City State Zip Code
Country Telephone
Email
Signature Date
Name (Print/Type)
Registration No.
This collection of information is required by 37 CFR 1.173. The information is required to obtain or retain a benefit by the public which is to file (and by the USPTO to
process) an application. Confidentiality is governed by 35 U.S.C. 122 and 37 CFR 1.11 and 1.14. This collection is estimated to take 12 minutes to complete, including
gathering, preparing, and submitting the completed application form to the USPTO. Time will vary depending upon the individual case. Any comments on the
amount of time you require to complete this form and/or suggestions for reducing this burden, should be sent to the Chief Information Officer, U.S. Patent and
Trademark Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313‐1450. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS. SEND
TO: Mail Stop Reissue, Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313‐1450.
If you need assistance in completing the form, call 1‐800‐PTO‐9199 and select option 2.
